Peds Respiratory Flashcards

1
Q

What is the most common Respiratory Disease seen in Children?

A

Acute Respiratory Infections

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2
Q

Are Acute Respiratory Infections Viral or Bacterial?

A

They can be either

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3
Q

Do Acute Respiratory Infections impact the Upper or Lower Respiratory System?

A

They can impact either

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4
Q

Where does the Upper Airway end and the Lower Airway start?

A

The Upper Airway ends above the Trachea, the Trachea and everything below it is the Lower Airway

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5
Q

How are Acute Respiratory Infections spread?

A

Infected Particles (Bacterial, Viral, Fungi) spread via Contact and Droplets

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6
Q

What do Acute Respiratory Infections do to the Airway?

A

Cause Inflammation of Airway Tissues, Nasal Drainage, and Congestion

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7
Q

What is the Incubation Period for an Acute Respiratory Infection?

A

1-3 Days, then Sudden Onset of Symptoms

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8
Q

How long does an Acute Respiratory Infection last for?

A

4 - 10 Days

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9
Q

What is the most common Acute Respiratory Infection?

A

Upper Respiratory Infections (URI’s)

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10
Q

What age group has the highest incidence rate of URI’s?

A

Kids under 5 YO

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11
Q

What are Acute Respiratory Infections most often caused by?

A

Viruses

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12
Q

When are Acute Respiratory Infections most often going to occur?

A

Winter and Spring

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13
Q

Is Prenatal History a very significant thing to consider in terms of Acute Respiratory Infection in children?

A

Yes

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14
Q

Why are children so at risk for Acute Respiratory Infection?

A

They’ve got an Immature Immune System + They share germs more readily

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15
Q

Between Children and Adults who’ve got an Acute Respiratory Infection, who is more symptomatic?

A

Children

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16
Q

Are the manifestations of Acute Respiratory Infection severe or minimal in terms of invasiveness?

A

They vary from Minimal to Severe

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17
Q

What are the Minimal symptoms of an Acute Respiratory Infection?

A

Sneezing + Coughing + Eye Drainage + Fatigue + Headache + Low Grade Fever

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18
Q

What are the More Serious symptoms of an Acute Respiratory Infection?

A

Tachypnea + Labored Breathing + Wheezing / Other Unexpected Sounds + Hypoxia (with/without Hypercapnia) + Retractions + Nasal Flaring + Changes in LOC (Can progress into a Minimally Responsive State)

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19
Q

What is the best way to diagnose a mild Acute Respiratory Infection?

A

Physical Assessment

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20
Q

Will a mild Acute Respiratory Infection require any kind of diagnostic testing?

A

No, just the Physical Assessment

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21
Q

What diagnostic tests may be done to diagnose an Acute Respiratory Infection?

A

Rapid, Simple Testing (Swabs for Throat Infections, Influenza A and B, Respiratory Syncytial Virus (RSV), or Covid 19 tests may be completed)

CXR (Chest X-Ray) and CBC Count with diff may be needed.

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22
Q

Can vaccines prevent any Acute Respiratory Infections?

A

Yes

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23
Q

What is Croup?

A

Upper & Middle Airway Edema that results in restricted airflow

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24
Q

What might Croup be caused by?

A

Allergens (Spasmodic) + Viruses (Viral) + Bacterial

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25
Q

How long is the duration of Croup Cough? Can it be an Emergency?

A

Short Duration, Self-Limiting, typically Non-Emergent

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26
Q

What is the main symptom of Croup?

A

A Barky Cough

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27
Q

When do the manifestations of Croup typically occur?

A

At Night

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28
Q

What Virus typically causes Viral Croup?

A

para-influenza

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29
Q

What are the symptoms of Viral Croup?

A

Respiratory Illness with Fever + Inflammation + Typically doesn’t repeat

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30
Q

What are the symptoms of Spasmodic Croup?

A

No Fever + Edema + Reoccurring + Manifestations most often occur at Night

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31
Q

Who are the people most at risk of Croup?

A

Kids aged 3 Months - 3 Yo.

People with a Family History OR a reported history of Nasal Drainage.

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32
Q

When does Croup most often occur?

A

Autumn + Early Winter

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33
Q

What are the manifestations of Croup during the first 2 days?

A

Nasal Congestion + Nasal Discharge

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34
Q

What is the other name for Nasal Discharge & Congestion?

A

Coryza

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35
Q

What are the manifestations of Croup during day 3?

A

Fever + Barky Cough + Hoarseness

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36
Q

What are the manifestations of Croup after day 3?

A

Edema of the Airway + Tachypnea & Prolonged Inspiratory Phase.

Respiratory Distress is possible if left untreated.

Anxiety / Agitation may occur before or after day 3.

37
Q

What is crucial in preventing the symptom escalation of Croup?

A

Early Intervention

38
Q

How is Croup diagnosed?

A

Can be diagnosed via Physical Assessment.

May need an X-Ray to assess Soft Tissue Edema.

WBC Count may be needed to rule out other infectious diseases.

39
Q

How is Croup treated?

A

Nebulized Meds + PO / INJ Steroids

Mechanical Ventilation (if Severe)

40
Q

In what ages is Croup often seen?

A

Croup only occurs during Childhood

41
Q

What does it mean if Croup is Self-Limiting?

A

It can often improve on it’s own without medical treatment

42
Q

Should Antibiotics ever be administered for Coup?

A

Nah

43
Q

Whenever inflammation occurs, what can happen with the Epiglottis?

A

It can completely cover the Trachea & cause Respiratory Failure

44
Q

What is an Inflamed Epiglottis called?

A

Epiglottitis

45
Q

What can Epiglottitis lead to if not immediately treated?

A

Cardiopulmonary Arrest

46
Q

What can Infectious Epiglottitis be caused by?

A

Infectious Particles that enter through the Nasopharyngeal Passages

Most Common:
Haemophilus Influenzae Type B (Hib)

47
Q

What age group is at the highest risk for Epiglottitis?

A

Children under 5 YO that are Unvaccinated against Hib

48
Q

Is Epiglottitis infectious or non-infectious?

A

Can be either

49
Q

What are some Non-Infectious causes of Epiglottitis?

A

Trauma:
Burns + Inhalation of Smoke / Chemicals / Heat

50
Q

Epiglottitis is usually not a medical emergency.
True or false?

A

False

51
Q

What’s the most common symptom of Epiglottitis?

A

Drooling

52
Q

What position do pt’s with Epiglottitis prefer to be in?

A

Orthopnea Position (Tripod Position)

53
Q

What is Bronchitis?

A

The Lining of the Bronchi become Edematous

54
Q

If Bronchitis occurs, what will the Bronchi do?

A

Produce Mucous (Causing a Coughing response)

55
Q

What are some causes of Bronchitis?

A

Influenza + Covid + RSV

56
Q

How is Bronchitis mainly treated?

A

With Hydration

57
Q

What are the risk factors of Bronchitis?

A

<2 YO + Premature Birth + Low Birth Weight + Underlying Lung Disease / Heart Condition + Immunocompromised

58
Q

What are the symptoms of Bronchitis?

A

Cough + Fever + Tachycardia + Wheezing & Crackles + History of Urinary Tract Infection + Labored Breathing + Hypoxia + Retractions

59
Q

Aside from Hydration, what are other things that can be done to treat Bronchitis?

A

Fever Management + Nasal Drops + Nasal Suctioning

60
Q

What do pt’s with Bronchitis need to be taught about?

A

How to recognize worsening symptoms + How to manage their symptoms

61
Q

What is Bronchiolitis?

A

Inflammation at the end of the Bronchioles

62
Q

What happens to your Epithelial Cells whenever you’ve got Bronchiolitis? What symptoms does this cause?

A

They become damaged and slough.

This results in Edema + Blocked Airway + Atelectasis + Excessive Mucous Production.

63
Q

What is Bronchiolitis typically caused by?

A

RSV

64
Q

In what age group is Bronchiolitis most common?

A

Children younger than 2 YO

65
Q

At what seasons does Bronchiolitis usually occur the most?

A

Autumn + Winter

66
Q

What does RSV stand for?

A

Respiratory Syncytial Virus

67
Q

How is RSV spread? What precautions should a pt with RSV be put on?

A

Spreads via direct contact via Nasal / Eye Mucous Membranes.

Droplet Precautions.

68
Q

How long does RSV last on surfaces?

A

For Hours

69
Q

How long is the Incubation Period for RSV?

A

4-6 Days

70
Q

How long does it take for RSV to go away once you get sick with it?

A

11 Days

71
Q

What seasons does RSV typically occur?

A

Fall to Early Spring

72
Q

In what age group does RSV affect? How does age impact the manifestations of RSV?

A

Seen in All Ages + Manifestations Lessen with Age

73
Q

What are the risk factors of RSV?

A

Infants younger than 6 Months Old + Premature Births + Born during Autumn or Winter + Low Birth Weight.

Down Syndrome + Underlying Heart / Lung Condition + Immunocompromised + Attend Daycare or have Older Siblings + Second Hand Smoke + Low Socioeconomic Status.

74
Q

What are the symptoms of RSV?

A

They Vary.

Lower Respiratory Tract Infections + Restricted Airflow, Increased Mucous Production, and Stasis + Wheezing / Crackles + Altered RR and Pattern + Bronchospasms that result in Severe Coughing + Tachycardia + Hypoxia

75
Q

How is RSV treated?

A

Hydration + Fever Management + Nasal Drops + Nasal Suctioning

76
Q

How is RSV treated/prevented Pharmacologically?

A

Palivizumab

Nirsemivab

Maternal Vaccine during Pregnancy

77
Q

How is RSV diagnosed?

A

Gold-Standard = Nasal Secretion Sample Test - Nasal Washing.

Others:
Nasal Swab (Can also test for other viruses).

The Polymerase Chain Reaction (PCR) Test.
(Most Preferred to confirm RSV).

78
Q

What is important to consider with Pediatric pt’s with RSV?

A

Smaller Airway = More Severe Symptoms

79
Q

What accounts for 1/3 of all Pharyngeal Infections?

A

Streptococcal Pharyngitis (Strep Throat)

80
Q

What bacteria causes Streptococcal Pharyngitis?

A

Group A Strep (GSA)

81
Q

What is occurring with a pt who has Strep Throat?

A

GSA enters through the Nasal Passages and attacks/invades the Epithelial Mucosal Lining of the Pharynx

82
Q

What are the risk factors for Strep Throat?

A

Pre-School & School-Age Kids

Winter & Spring Months

83
Q

What are the symptoms of Strep Throat?

A

Sore Throat without Nasal Drainage and Fever.

Red Throat + Petechiae (White Patchy Exudate on the Pharynx).

Red Tongue that looks like a Strawberry.

Rough, Red, Sandpaper-Like Rash on the Trunk of the Body (Scarlatina Rash).

84
Q

If a pt has Cervical Lymphadenopathy (Swollen Lymph Nodes of the Neck), which one is more likely?

Bacterial Strep Throat or Viral Strep Throat?

A

Bacterial Strep Throat

85
Q

How can Strep Throat be diagnosed?

A

Swab for GAS Bacteria.

If the pt has a negative GAS test but Strep Throat is still suspected, perform a Blood Culture to prevent a Misdiagnosis.

86
Q

How is Strep Throat treated?

A

Appropriate Antibiotics (Typically, PO is prescribed).

If the pt is non-compliant, administer a 1-Time IM injection of Penicillin.

87
Q

How will Antibiotics need to be dosed for a pt with Strep Throat?

A

Dose depends on the pt’s Age + Weight

88
Q

A pt with Strep is taking Antibiotics, should they keep taking them even after they feel better?

A

Yes